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Smoking and body fat mass in relation to bone mineral density and hip fracture: the Hordaland Health Study.
PLoS One 2014; 9(3):e92882Plos

Abstract

Lower bone mineral density (BMD) in smokers may be attributable to lower body weight or fat mass, rather than to a direct effect of smoking. We analyzed the effects of smoking exposure, assessed by plasma cotinine, and body fat on BMD and the risk of subsequent hip fracture. In the community-based Hordaland Health Study (HUSK), 3003 participants 46-49 years and 2091 subjects 71-74 years were included. Cotinine was measured in plasma and information on health behaviors was obtained from self-administered questionnaires. BMD and total body soft tissue composition were measured by dual X-ray absorptiometry. Information on hip fracture was obtained from computerized records containing discharge diagnoses for hospitalizations between baseline examinations 1997-2000 through December 31st, 2009. In the whole cohort, moderate and heavy smokers had stronger positive associations between fat mass and BMD compared to never smokers (differences in regression coefficient (95% CI) per % change in fat mass = 1.38 (0.24, 2.52) and 1.29 (0.17, 2.4), respectively). In moderate and heavy smokers there was a nonlinear association between BMD and fat mass with a stronger positive association at low compared to high levels of fat mass (Davies segmented test, p<0.001). In elderly women and men, heavy smokers had an increased risk of hip fracture compared to never smokers (hazard ratio = 3.31, 95% CI: 2.05, 5.35; p<0.001). In heavy smokers there was a tendency of a lower risk of hip fracture with higher percentage of fat mass. The deleterious effect of smoking on bone health is stronger in lean smokers than in smokers with high fat mass.

Authors+Show Affiliations

Department of Rheumatology, Haukeland University Hospital, Bergen, Norway; Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.Department of Rheumatology, Haukeland University Hospital, Bergen, Norway; Department of Clinical Science, University of Bergen, Bergen, Norway.Department of Clinical Science, University of Bergen, Bergen, Norway; Department of Heart Disease, Haukeland University Hospital, Bergen, Norway.Department of Clinical Dentistry, University of Bergen, Bergen, Norway.Section for Preventive Medicine and Epidemiology, University of Oslo, Oslo, Norway; Norwegian Institute of Public Health, Division of Epidemiology, Oslo, Norway.Department of Rheumatology, Haukeland University Hospital, Bergen, Norway; Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.Department of Clinical Science, University of Bergen, Bergen, Norway; Laboratory of Clinical Biochemistry, Haukeland University Hospital, Bergen, Norway.Department of Clinical Science, University of Bergen, Bergen, Norway.Bevital AS, Bergen, Norway.Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.

Pub Type(s)

Clinical Trial
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

24667849

Citation

Øyen, Jannike, et al. "Smoking and Body Fat Mass in Relation to Bone Mineral Density and Hip Fracture: the Hordaland Health Study." PloS One, vol. 9, no. 3, 2014, pp. e92882.
Øyen J, Gram Gjesdal C, Nygård OK, et al. Smoking and body fat mass in relation to bone mineral density and hip fracture: the Hordaland Health Study. PLoS ONE. 2014;9(3):e92882.
Øyen, J., Gram Gjesdal, C., Nygård, O. K., Lie, S. A., Meyer, H. E., Apalset, E. M., ... Tell, G. S. (2014). Smoking and body fat mass in relation to bone mineral density and hip fracture: the Hordaland Health Study. PloS One, 9(3), pp. e92882. doi:10.1371/journal.pone.0092882.
Øyen J, et al. Smoking and Body Fat Mass in Relation to Bone Mineral Density and Hip Fracture: the Hordaland Health Study. PLoS ONE. 2014;9(3):e92882. PubMed PMID: 24667849.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Smoking and body fat mass in relation to bone mineral density and hip fracture: the Hordaland Health Study. AU - Øyen,Jannike, AU - Gram Gjesdal,Clara, AU - Nygård,Ottar Kjell, AU - Lie,Stein Atle, AU - Meyer,Haakon E, AU - Apalset,Ellen Margrete, AU - Ueland,Per Magne, AU - Pedersen,Eva Ringdal, AU - Midttun,Øivind, AU - Vollset,Stein Emil, AU - Tell,Grethe S, Y1 - 2014/03/25/ PY - 2013/11/13/received PY - 2014/02/26/accepted PY - 2014/3/27/entrez PY - 2014/3/29/pubmed PY - 2014/12/31/medline SP - e92882 EP - e92882 JF - PloS one JO - PLoS ONE VL - 9 IS - 3 N2 - Lower bone mineral density (BMD) in smokers may be attributable to lower body weight or fat mass, rather than to a direct effect of smoking. We analyzed the effects of smoking exposure, assessed by plasma cotinine, and body fat on BMD and the risk of subsequent hip fracture. In the community-based Hordaland Health Study (HUSK), 3003 participants 46-49 years and 2091 subjects 71-74 years were included. Cotinine was measured in plasma and information on health behaviors was obtained from self-administered questionnaires. BMD and total body soft tissue composition were measured by dual X-ray absorptiometry. Information on hip fracture was obtained from computerized records containing discharge diagnoses for hospitalizations between baseline examinations 1997-2000 through December 31st, 2009. In the whole cohort, moderate and heavy smokers had stronger positive associations between fat mass and BMD compared to never smokers (differences in regression coefficient (95% CI) per % change in fat mass = 1.38 (0.24, 2.52) and 1.29 (0.17, 2.4), respectively). In moderate and heavy smokers there was a nonlinear association between BMD and fat mass with a stronger positive association at low compared to high levels of fat mass (Davies segmented test, p<0.001). In elderly women and men, heavy smokers had an increased risk of hip fracture compared to never smokers (hazard ratio = 3.31, 95% CI: 2.05, 5.35; p<0.001). In heavy smokers there was a tendency of a lower risk of hip fracture with higher percentage of fat mass. The deleterious effect of smoking on bone health is stronger in lean smokers than in smokers with high fat mass. SN - 1932-6203 UR - https://www.unboundmedicine.com/medline/citation/24667849/Smoking_and_body_fat_mass_in_relation_to_bone_mineral_density_and_hip_fracture:_the_Hordaland_Health_Study_ L2 - http://dx.plos.org/10.1371/journal.pone.0092882 DB - PRIME DP - Unbound Medicine ER -